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   Table of Contents - Current issue
Coverpage
July-December 2021
Volume 12 | Issue 2
Page Nos. 39-75

Online since Thursday, February 24, 2022

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REVIEW ARTICLE  

The hemotological profile in COVID-19 infection: A mini-review p. 39
Olufunto Olufela Kalejaiye, Babatunde M Duduyemi
DOI:10.4103/atp.atp_5_21  
The report of clusters of pneumonia-like cases in Wuhan, China, on December 31, 2019, began a tumultuous cascade of health, social, and economic disruptions globally. Consequently, this resulted in the coronavirus disease-2019 (COVID-19) pandemic, described as one of the most lethal pandemics the world has had to face. Several aspects of infection and its implications on different organ systems have been reported in formal literature, with more studies generated daily. Although the infection is reported to be dominantly respiratory, it may result in multisystem dysfunction. In this review, we discuss the hematological abnormalities induced by COVID-19 infection. These findings could contribute to a better understanding of the disease pathophysiology and ultimately guide in prognostication, guide assessment, monitoring, and treatment approaches and help develop targeted adjuvant therapies.
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ORIGINAL ARTICLES Top

Microscopic assessments of the effect of phoenix dactylifera L. in a rat model of mercury-triggered cerebral M1 changes p. 43
Abel Nosereme Agbon, Helen Ochuko Kwanashie, Wilson Oliver Hamman, Austin Oseloka Ibegbu, Hamisu Sule, Murtala Hamza Yahaya, Rachael Henry, Andrew Ekpenyong Ivang
DOI:10.4103/atp.atp_3_21  
Context: Mercury is a widespread environmental and industrial pollutant that exerts toxic effects on vital organs. The cerebrum, composed of cortical areas such as the primary motor cortex (M1), is a vulnerable target of mercury toxicity within the central nervous system. Phoenix dactylifera is used in folk medicine to treat diverse disorders, such as loss of consciousness, memory disturbances, and nervous disorders. Aim: This study microscopically evaluated the neuroprotective effect of aqueous fruit pulp extract of P. dactylifera (AFPD) on mercury-triggered M1 changes in Wistar rats. Materials and Methods: Twenty-four Wistar rats were divided into six groups (I–VI; n = 4). Group I was administered distilled water (2 ml/kg); Group II administered mercuric chloride (MCL, 5 mg/kg); Group III administered Vitamin C (100 mg/kg) + MCL (5 mg/kg); Groups IV, V, and VI were administered AFPD (250 mg/kg, 500 mg/kg, and 1000 mg/kg, respectively) followed by MCL (5 mg/kg). Neuroprotective property was evaluated by microscopic assessment of M1 region applying histological techniques and analysis of histometric features of M1 neurons. Statistical Analysis Used: One-way ANOVA and paired sample t-test were used. Results: Microscopic examination of MCL-treated cerebral sections revealed M1 histoarchitectural distortion and neurodegenerative changes such as pyknosis, neuronal shrinkage, chromatolysis, loss of pyramidal neurites, and altered Nissl substance reactivity, relative to the control. Administration of AFPD remarkably ameliorated MCL-triggered M1 changes, especially at dose 500 mg/kg with neuroprotective property comparable to the reference drug, Vitamin C. Conclusion: AFPD is potentially efficacious in ameliorating mercury-triggered microscopic alterations in M1 region of Wistar rats. The neuroprotective property of AFPD could be attributed to antioxidant properties of constituent phytochemicals.
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Prevalence of Vitamin B12 deficiency in antiretroviral therapy naïve adults with human immunodeficiency virus infection in a human immunodeficiency virus treatment center in Lagos, Nigeria p. 53
Olufunto Olufela Kalejaiye, Babatunde M Duduyemi, Christian Okechukwu Onalu, Olufemi Samuel Amoo, Nkiruika Nnoyelum Odunukwe, Njideka Ulunma Okubadejo, Michael Olufemi Kehinde
DOI:10.4103/atp.atp_6_21  
Background: Vitamin B12 deficiency is reportedly higher in human immunodeficiency virus (HIV) infection, according to reports from developed countries and is associated with worsening anemia, progressing immunodeficiency (reduced CD4 count), and reduced survival rates. The status in Nigerians with HIV has not been extensively studied. The objective of the study was to determine the frequency and correlates of Vitamin B12 deficiency in HIV-positive antiretroviral therapy (ART) naive patients attending an outpatient HIV clinic in Lagos, Nigeria. Specifically, the study compared HIV-positive ART-naïve patients to age- and gender-matched HIV-negative controls and determined the relationship between B12 status and HIV disease severity (CD4 count) and hemoglobin (Hb). Methodology: The study was a descriptive study of the prevalence of Vitamin B12 deficiency and its correlation with disease severity in HAART-naïve newly diagnosed HIV infection. Seventy-five ART naïve, HIV-positive patients and 75 controls fulfilling the study criteria were included. Baseline hematologic (Hb, white blood cell, platelets, and CD4 count) and Vitamin B12 levels were measured. Vitamin B12 levels were measured using urine methylmalonic acid (MMA) on spot urine normalized for urine creatinine. B12 deficiency was defined as urine MMA >3.6 mmol/mol urinary creatinine. CD4 count (cells/μL) was categorized as <200, 200–499, and >500. Results: The frequency of B12 deficiency was 29.3% (22/75) in HIV-positive cases and 0% (0/75) in controls (P < 0.001). There was no difference in the frequency of anemia in HIV cases with or without B12 deficiency (54.5% vs. 58.5%; P = 0.75). There was no significant difference in the proportions of HIV cases with or without B12 deficiency in the CD4 categories 1 (>500), 2 (200-499) and 3 (<200), (1: 31.8% vs. 24.5%; 2: 40.9% vs. 50.9%; 3: 27.5% vs. 24.5%, respectively; P = 0.71). Neither severity of HIV infection nor Hb levels was found to be associated with B12 status (P > 0.05). Conclusion: Vitamin B12 deficiency was more prevalent in HIV-positive ART naïve cases compared to age- and gender-matched HIV-negative controls. However, the presence of B12 deficiency was not associated with anemia or the severity of HIV infection in this study.
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Immunohistochemical study of the role of human papillomavirus, epstein–barr virus, and P16INK4a expression in head-and-neck squamous cell carcinomas p. 61
Babatunde Moses Duduyemi, Evans Aboagye
DOI:10.4103/atp.atp_7_21  
Background: Studies over the years have established that human papillomavirus (HPV) and Epstein–Barr virus (EBV) are major etiological agents in subsets of head-and-neck squamous cell carcinomas (HNSCCs). This study further explores the concurrence of HPV and EBV together with P16INK4a expression in HNSCCs, providing additional insights into their unique role in establishing a virus-induced carcinogenesis. Materials and Methods: A retrospective cross-sectional study utilizing immunohistochemistry was employed to establish the presence of HPV, EBV, and P16INK4a expression in HNSCC archived tissue samples. Results: A total of 121 selected HNSCC cases were included in the study, with male preponderance (n = 86) and majority of the cases occurring in patients ≤54 (n = 62). The most common site of occurrence was the oral cavity (n = 29), followed by larynx (n = 27) and nasal cavity and paranasal sinuses (n = 24), respectively. The study recorded 18 (14.9%) HPV-positive tumors, 7 (5.8%) EBV-positive tumors, and 2 (1.7%) tumors coinfected with HPV and EBV. P16INK4a expression was recorded in 42.1% (n = 51) of the tumors. Although P16INK4a expression correlated weakly with both HPV (r = 0.116) and EBV (r = 0.205) positivity, it showed a statistically significant expression with EBV positivity (P = 0.024). Conclusion: The observed pattern of HPV association with P16INK4a overexpression was consistent with earlier reported studies, and as such, the study reinforces the assertion that P16INK4a can be used as a surrogate marker for HPV-positive tumors. However, additional studies are required to validate its suitability in tumor sites other than oropharyngeal squamous cell carcinoma.
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The relationship between some haematological parameters with length of stay and outcome in the intensive care unit of a tertiary health facility in Zaria, Northwestern Nigeria p. 66
Rufai Abdu Dachi, Sani Awwalu, Saleh Yuguda, Ismaila Nda Ibrahim, Yusuf Rasheed, Elizabeth Nwasor Ogboli
DOI:10.4103/atp.atp_8_21  
Introduction: Intensive care units (ICUs) are reserved for critically ill patients that need specialist medical care with close and constant attention provided. Patients admitted into ICUs could have myriads of hematological abnormalities some of which have direct bearing on disease severity and outcome. There is a paucity of data on the relationship between hematological parameters of ICU patients and length of ICU stay as well as outcome in our environment, hence the need for this study. Materials and Methods: This study was a prospective observational one, in which patients that are ≥18 years of age and had no blood transfusion within 24 h before ICU admission into the ICU of Ahmadu Bello University Teaching Hospital, Zaria, were recruited over a 3-month period from March 1, 2018 to May 31, 2018. Participants' sociodemographic characteristics, indications for admission, and some hematological parameters were assessed. Length of stay and outcome were also determined. Venous blood was collected from the patients for the determination of full blood count. Data were collated and analyzed using SPSS Version 20.0. Level of statistical significance was set at P ≤ 0.05. Results: Thirty-nine participants were enrolled into the study with a mean ± standard deviation (SD) age of 32.7 ± 15.8 years. Females constituted 21/39 (53.8%) of the participants. The mean ± SD hematocrit (HCT) and blood cell count (WBC) were 28.1% ± 6.1% and 11.5 ± 4.3 (× 109/L), respectively, whereas the median (interquartile range [IQR]) platelet (PLT) count was 125.5 ± 82.4 (× 109/L). There was a positive, moderately strong, and statistically significant correlation between the duration of stay in ICU with WBC count. There were statistically significant differences in HCT, PLT, and WBC across categories of indication for admission into ICU (obstetrics complications, medical conditions, orthopedics/trauma, postoperative cases, and burns). The median (IQR) duration of ICU stay (days) in this study was 3.8 (1.9) days, and 18/39 (46.2%) were discharged home directly from the ICU. Conclusion: Anemia, leukopenia, and thrombocytopenia are common and vary according to the indications for admission and are associated with duration of stay and outcome in patients admitted into ICU in Zaria, Northwestern Nigeria.
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Pattern of pseudomonas aeruginosa infection among Northwestern Nigerians with chronic suppurative otitis media p. 71
Abdulrazak Ajiya, Iliyasu Yunusa Shuaibu, Auwal Adamu, Hamisu Abdullahi, Abdulazeez Omeiza Ahmed, Shofoluwe Nurudeen Adebola, Abdullahi Musa Kirfi, Usman Mohammed Aminu
DOI:10.4103/atp.atp_14_21  
Background: Pseudomonas aeruginosa has been particularly blamed for the deep-seated and progressive destruction of the middle ear and mastoid structure through its toxins and enzymes. Drug-resistant P. aeruginosa has been found to increase along with its frequency. Aim: This study aimed to assess the antibiotic sensitivity pattern of P. aeruginosa and the effectiveness of ciprofloxacin in chronically discharging ears. Patients and Methods: This was a retrospective review of 180 patients who were managed for chronic suppurative otitis media between January 2009 and December 2018. Results: Out of the 180 patients, majority 67 (37%) were in the age group 1–10 years, range of 1 month to 70 years with mean age of 18 years and standard deviation of ± 16.8 years and M: F of 1.5:1. Most have had ear discharge for more than 6 months and the majority 78 (43.4%) of the patients had bilateral disease. Central tympanic membrane perforation was the predominant finding, 81 (45.0%) with a complication rate of 21.1%. Abscess formation was the most common complication seen among the patients. P. aeruginosa was the most common bacterial isolate, 43 (23.9%) followed by Staphylococcus aureus, 39 (21.7%). In the pediatric population, P. aeruginosa was most sensitive to levofloxacin, as opposed to gentamicin in the adult population. Ciprofloxacin was seen to be more effective in adults than in children. Resistance to ciprofloxacin was seen more in the children than in adults. There was a significant association between gender and occurrence of the organism. Conclusion: P. aeruginosa is most sensitive to levofloxacin and gentamicin in the pediatric and adult population, respectively. Resistance to ciprofloxacin is most common among adults.
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